Provider Demographics
NPI:1750608378
Name:GENTRY, ANN H (RN)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:H
Last Name:GENTRY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8532 E KENYON DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-4232
Mailing Address - Country:US
Mailing Address - Phone:520-886-4892
Mailing Address - Fax:
Practice Address - Street 1:5455 S CARDINAL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85746-2168
Practice Address - Country:US
Practice Address - Phone:520-908-5417
Practice Address - Fax:520-908-5403
Is Sole Proprietor?:No
Enumeration Date:2010-04-21
Last Update Date:2010-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN071790163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool